Category: Allied Healthcare Professionals
Objective: To characterize patients at a new diverse, academic Parkinson’s Disease (PD) interdisciplinary clinic (IDC).
Background: PD affects patients in nearly all spheres of life, including motor and nonmotor manifestations.[1] Patient age, gender, Movement Disorder Society Unified PD Rating Scale (MDS-UPDRS) scores, and certain cognitive metrics have been used to create models predicting progression to Hoehn & Yahr stage 3.[2] The need for care teams incorporating multiple specialties is increasingly being recognized.[3] Short-term intensive multidisciplinary care provides immediate motor and nonmotor benefits, and outpatient-based integrative care improves quality of life.[4,5]
Method: The University of Miami (UM) recently opened a PD IDC where patients are evaluated by neurology, physical and occupational therapy, nutrition, speech and language pathology, social work, and neuropsychology providers during one session. The IDC team then forms a holistic care plan for each patient.
We performed a retrospective chart review of all patients evaluated in the UM PD IDC in its first year of operation, from January 1 – December 1, 2022.
Results: Thirty patients were seen at the IDC in its first year [Table 1]. The average age of patients was 68.4 years; 40% were female, 80% were White, 13.3% were Black, and 43.3% identified as Hispanic/Latino. Patients presented with an average Hoehn & Yahr Stage of 2.7 and MDS-UPDRS Motor Score of 30.3 [Table 2]. Ranges for most baseline metrics varied considerably.
Conclusion: The patient population seen at the UM PD IDC during its first year was notably diverse, with 43.3% identifying as Hispanic/Latino and 13.3% as Black. The importance of more inclusive PD research has gained attention, but there is still a large knowledge gap surrounding the impact of race and ethnicity on PD.[6,7] Our IDC, with its robust Hispanic/Latino population, has the potential to illuminate further ethnic and racial differences as patients are followed longitudinally.
Patients exhibited a wide range of scores on baseline functional measures, likely reflecting a lack of strict referral criteria. Neuropsychological screening, while not initially available at the opening of the IDC, is now routinely performed on all patients, including assessment of mood and verbal fluency. Further directions for this research include long-term follow-up of our patients, incorporating analysis of these metrics over time.
References: 1. Bloem BR, Okun MS, Klein C. Parkinson’s disease. The Lancet. 2021;397(10291):2284-2303.
2. Ren X, Lin J, Stebbins GT, Goetz CG, Luo S. Prognostic Modeling of Parkinson’s Disease Progression Using Early Longitudinal Patterns of Change. Mov Disord. 2021;36(12):2853-2861.
3. Radder DLM, de Vries NM, Riksen NP, et al. Multidisciplinary care for people with Parkinson’s disease: the new kids on the block! Expert Rev Neurother. 2019;19(2):145-157.
4. Trend P, Kaye J, Gage H, Owen C, Wade D. Short-term effectiveness of intensive multidisciplinary rehabilitation for people with Parkinson’s disease and their carers. Clin Rehabil. 2002;16(7):717-725.
5. Rajan R, Brennan L, Bloem BR, et al. Integrated Care in Parkinson’s Disease: A Systematic Review and Meta-Analysis. Mov Disord. 2020;35(9):1509-1531.
6. Sauerbier A, Aris A, Lim EW, Bhattacharya K, Ray Chaudhuri K. Impact of ethnicity on the natural history of Parkinson disease. Med J Aust. 2018;208(9):410-414.
7. Ben-Joseph A, Marshall CR, Lees AJ, Noyce AJ. Ethnic Variation in the Manifestation of Parkinson’s Disease: A Narrative Review. J Parkinsons Dis. 2020;10(1):31-45.
To cite this abstract in AMA style:
V. Armengol, M. Sarno, M. Feldman, S. Marmol, A. Alfonso, G. Dumenigo, M. Garcia-Casals, S. Munzesheimer, A. Otto, TW. Siu, D. Shpiner. A baseline study for the first year of a diverse Parkinson’s Disease interdisciplinary clinic [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/a-baseline-study-for-the-first-year-of-a-diverse-parkinsons-disease-interdisciplinary-clinic/. Accessed September 7, 2024.« Back to 2023 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/a-baseline-study-for-the-first-year-of-a-diverse-parkinsons-disease-interdisciplinary-clinic/